@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<https://exchange.example.org/fhir/ig/340b-exchange/Claim/claim-chargeback-001> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "claim-chargeback-001"] ; # 
  fhir:meta [
     fhir:profile ( [
       fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-claim"^^xsd:anyURI ;
       fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-claim>
     ] )
  ] ; # 
  fhir:text [
     fhir:status [ fhir:v "extensions" ] ;
     fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim claim-chargeback-001</b></p><a name=\"claim-chargeback-001\"> </a><a name=\"hcclaim-chargeback-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-340b-claim.html\">340B Claim Profile</a></p></div><p><b>340B Correlation ID Extension</b>: corr-cb-7721</p><p><b>340B Exchange Transaction ID Extension</b>: tx-cb-7721</p><p><b>340B Rule Set Version Extension</b>: 1.2.0</p><p><b>340B Chargeback Reference Extension</b>: <code>https://exchange.example.org/chargeback</code>/cb-7721</p><p><b>identifier</b>: <code>https://exchange.example.org/claim-ids</code>/claim-7721</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type pharmacy}\">Pharmacy</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-p-001.html\">Pat Example  (no stated gender), DoB Unknown</a></p><p><b>created</b>: 2026-04-24</p><p><b>insurer</b>: <a href=\"Organization-manufacturer-77.html\">Organization Example Manufacturer 77</a></p><p><b>provider</b>: <a href=\"Organization-pharmacy-22.html\">Organization Example Pharmacy 22</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-cov-001.html\">Coverage: status = active</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://example.org/drug-codes 00000-1111-22}\">00000-1111-22</span></td></tr></table></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
     fhir:url [
       fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id"^^xsd:anyURI ;
       fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id>
     ] ;
     fhir:value [
       a fhir:String ;
       fhir:v "corr-cb-7721"
     ]
  ] [
     fhir:url [
       fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id"^^xsd:anyURI ;
       fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id>
     ] ;
     fhir:value [
       a fhir:String ;
       fhir:v "tx-cb-7721"
     ]
  ] [
     fhir:url [
       fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-rule-set-version"^^xsd:anyURI ;
       fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-rule-set-version>
     ] ;
     fhir:value [
       a fhir:String ;
       fhir:v "1.2.0"
     ]
  ] [
     fhir:url [
       fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-chargeback-reference"^^xsd:anyURI ;
       fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-chargeback-reference>
     ] ;
     fhir:value [
       a fhir:Identifier ;
       fhir:system [
         fhir:v "https://exchange.example.org/chargeback"^^xsd:anyURI ;
         fhir:l <https://exchange.example.org/chargeback>
       ] ;
       fhir:value [ fhir:v "cb-7721" ]
     ]
  ] ) ; # 
  fhir:identifier ( [
     fhir:system [
       fhir:v "https://exchange.example.org/claim-ids"^^xsd:anyURI ;
       fhir:l <https://exchange.example.org/claim-ids>
     ] ;
     fhir:value [ fhir:v "claim-7721" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
     fhir:coding ( [
       fhir:system [
         fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
         fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>
       ] ;
       fhir:code [ fhir:v "pharmacy" ]
     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
     fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/Patient/p-001> ;
     fhir:reference [ fhir:v "Patient/p-001" ]
  ] ; # 
  fhir:created [ fhir:v "2026-04-24"^^xsd:date] ; # 
  fhir:insurer [
     fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/Organization/manufacturer-77> ;
     fhir:reference [ fhir:v "Organization/manufacturer-77" ]
  ] ; # 
  fhir:provider [
     fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/Organization/pharmacy-22> ;
     fhir:reference [ fhir:v "Organization/pharmacy-22" ]
  ] ; # 
  fhir:priority [
     fhir:coding ( [
       fhir:system [
         fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ;
         fhir:l <http://terminology.hl7.org/CodeSystem/processpriority>
       ] ;
       fhir:code [ fhir:v "normal" ]
     ] )
  ] ; # 
  fhir:insurance ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:focal [ fhir:v true ] ;
     fhir:coverage [
       fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/Coverage/cov-001> ;
       fhir:reference [ fhir:v "Coverage/cov-001" ]
     ]
  ] ) ; # 
  fhir:item ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:productOrService [
       fhir:coding ( [
         fhir:system [
           fhir:v "http://example.org/drug-codes"^^xsd:anyURI ;
           fhir:l <http://example.org/drug-codes>
         ] ;
         fhir:code [ fhir:v "00000-1111-22" ]
       ] )
     ]
  ] ) . # 

# -------------------------------------------------------------------------------------